ABSTRACT
OBJECTIVE: People with epilepsy are at an increased risk of experiencing executive dysfunction, particularly those with frontal lobe epilepsy (FLE). The literature has also demonstrated alterations in executive functioning (EF) in patients with temporal lobe epilepsy (TLE). However, few studies have examined the neuropsychological profile of posterior cortex epilepsy (PCE), and little attention has been given to cognitive impairments in the pediatric population with PCE. This study aims to investigate EF performance in children with drug-resistant PCE compared to patients with FLE and TLE. METHODS: We analyzed neuropsychological data from 217 patients aged 6-18 years who underwent preoperative evaluation for epilepsy surgery. The EF of patients with PCE was compared to patients with FLE and TLE. RESULTS: There was no significant difference in Full-Scale Intelligence Quotient (FSIQ) means between groups. However, we found a significant effect of brain region on the Coding task, in which patients with PCE and FLE performed worse than those with TLE (p = 0.034). We also observed performance differences between groups on the Stroop test (p = 0.005), with patients with PCE and FLE performing worse than the TLE group. SIGNIFICANCE: These findings suggest that children with PCE have alterations in their EF that are similar to the deficits found in FLE compared to patients with TLE. This emphasizes the importance of understanding the neuroanatomy of executive functions and the model of neural networks extending beyond the prefrontal cortex.
Subject(s)
Epilepsy, Frontal Lobe , Epilepsy, Temporal Lobe , Humans , Child , Executive Function , Neuropsychological Tests , Brain , Frontal LobeABSTRACT
BACKGROUND: Cognitive functioning in epileptic syndromes has been widely explored in patients with temporal lobe epilepsy (TLE), but few studies have investigated the neuropsychological profile in posterior cortex epilepsy (PCE). In this study, we investigated the presurgical intellectual profile of children and adolescents with drug-resistant PCE. METHODS: Children and adolescents diagnosed with PCE (nâ¯=â¯25) participated in this study. The data were obtained from medical records, with assessments carried out between the years 2003 and 2019. To compare the intellectual profile, we also included patients diagnosed with frontal (nâ¯=â¯26) and temporal lobe epilepsy (nâ¯=â¯40). The Wechsler Intelligence Scales were used for the assessment of general intelligence. RESULTS: There was an effect of the brain region on the Working Memory Index (pâ¯<â¯0.01), in which patients with TLE had significantly higher scores than groups with FLE (pâ¯<â¯0.01) and PCE (pâ¯<â¯0.05). We also demonstrated that patients with PCE tended to perform worse in the Processing Speed Index than patients with TLE (pâ¯=â¯0.055). The Full-Scale Intelligence Quotient, Verbal Comprehension, and Perceptual Reasoning indexes did not differ among the brain regions. CONCLUSIONS: Children and adolescents with PCE demonstrated significant impairment in working memory and processing speed. The pattern of cognitive dysfunction in PCE was similar to that observed in FLE, which expands the evidence of the involvement of frontoparietal networks on cognitive proficiency.
Subject(s)
Epilepsy, Temporal Lobe , Epilepsy , Adolescent , Child , Cognition , Epilepsy, Temporal Lobe/complications , Humans , Intelligence , Neuropsychological TestsABSTRACT
OBJECTIVE: We aimed to evaluate long-term surgical outcomes in patients treated for mesial temporal lobe epilepsy compared with a similar group of patients who underwent a preoperative evaluation. METHODS: Patient interviews were conducted by an independent neuropsychologist and included a sociodemographic questionnaire and validated versions of the Beck Depression Inventory-II, Adverse Events Profile, Quality of Life in Epilepsy-31, and Rey Auditory Verbal Learning Test. RESULTS: Seventy-one patients who underwent surgery and 20 who underwent mesial temporal lobe epilepsy preoperative evaluations were interviewed. After an 81-month mean postoperative follow-up, 44% of the surgical patients achieved complete seizure relief according to the Engel classification and 68% according to the International League Against Epilepsy classification. The surgical group had a significantly lower prevalence of depression (P = 0.002) and drug-related adverse effects (P = 0.002). Improvement on unemployment (P = 0.02) was achieved but not on driving or education. Delayed verbal memory recall was impaired in 76% of the surgical and 65% of the control cases (P = 0.32). Regarding the Quality of Life in Epilepsy-31, the operated patients scored higher in their total score (mean, 75.44 vs. mean, 60.08; P < 0.001) and in all but the cognitive functioning domain irrespective of the follow-up length. Seizure control, Beck Depression Score, and Adverse Events Profile severity explained 73% of the variance in the surgical group quality of life. CONCLUSIONS: Our study found that, although surgical treatment was effective, its impact on social indicators was modest. Moreover, the self-reported quality of life relied not only on seizure control but also on depressive symptoms and antiepileptic drug burden.
Subject(s)
Cross-Cultural Comparison , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Epilepsy, Temporal Lobe/psychology , Epilepsy, Temporal Lobe/surgery , Neuropsychological Tests/statistics & numerical data , Postoperative Complications/diagnosis , Postoperative Complications/psychology , Psychometrics/statistics & numerical data , Quality of Life/psychology , Retention, Psychology , Surveys and Questionnaires , Verbal Learning , Adolescent , Adult , Aged , Anticonvulsants/therapeutic use , Cohort Studies , Combined Modality Therapy , Cost of Illness , Female , Follow-Up Studies , Humans , Interview, Psychological , Male , Middle Aged , Outcome Assessment, Health Care/statistics & numerical data , Young AdultABSTRACT
OBJECTIVE: Characterize the social profile and the need of information from patients with refractory epilepsy. METHOD: A semi-structured questionnaire was applied to 103 patients to investigate sociodemographic aspects, pharmacotherapy and any doubts about epilepsy. RESULTS: Patients were highly dependent on having a free and accessible supply of antiepileptic drugs. Sixty-eight percent of the population was unemployed, and 26% confirmed receiving social security benefits due to epilepsy. Twenty-nine percent of the population reached high school. Eighty-five percent of the patients had at least one doubt about epilepsy; treatment and epilepsy aspects in general were the main topics. CONCLUSION: As observed in developed countries, patients with refractory epilepsy from a developing country also have high rates of unemployment and low educational levels. The results raise a concern about the need of information about epilepsy by patients and their families, urging the necessity to invest in strategies to solve this deficiency in knowledge.
Subject(s)
Epilepsy/epidemiology , Health Knowledge, Attitudes, Practice , Tertiary Care Centers/statistics & numerical data , Adult , Anticonvulsants/therapeutic use , Brazil/epidemiology , Epilepsy/psychology , Female , Humans , Male , Middle Aged , Social Security , Socioeconomic Factors , Surveys and Questionnaires , Unemployment/statistics & numerical dataABSTRACT
Objective Characterize the social profile and the need of information from patients with refractory epilepsy. Method A semi-structured questionnaire was applied to 103 patients to investigate sociodemographic aspects, pharmacotherapy and any doubts about epilepsy. Results Patients were highly dependent on having a free and accessible supply of antiepileptic drugs. Sixty-eight percent of the population was unemployed, and 26% confirmed receiving social security benefits due to epilepsy. Twenty-nine percent of the population reached high school. Eighty-five percent of the patients had at least one doubt about epilepsy; treatment and epilepsy aspects in general were the main topics. Conclusion : As observed in developed countries, patients with refractory epilepsy from a developing country also have high rates of unemployment and low educational levels. The results raise a concern about the need of information about epilepsy by patients and their families, urging the necessity to invest in strategies to solve this deficiency in knowledge. .
Objetivo : Caracterizar o perfil social e a necessidade de informações por parte de pacientes com epilepsia refratária. Método Um questionário semi-estruturado foi aplicado a 103 pacientes para investigar aspectos sociodemográficos, farmacoterapia e quaisquer dúvidas sobre epilepsia. Resultados Os pacientes mostraram-se altamente dependentes de um fornecimento gratuito e acessível de drogas antiepilépticas. Sessenta e oito por cento da população estava desempregada, e 26% confirmaram receber algum benefício social devido à epilepsia. Vinte e nove por cento da população alcançou ensino médio. Oitenta e cinco por cento dos pacientes tinha ao menos uma dúvida sobre epilepsia; tratamento e aspectos gerais da epilepsia foram os principais temas. Conclusão Tal qual observado em países desenvolvidos, pacientes com epilepsia refratária em países em desenvolvimento também apresentam altas taxas de desemprego e baixos níveis educacionais. Os resultados são preocupantes no que diz respeito à necessidade de informações sobre epilepsia por parte dos pacientes e seus familiares, apontando a necessidade de se investir em estratégias que solucionem esta deficiência de conhecimento. .
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Epilepsy/epidemiology , Health Knowledge, Attitudes, Practice , Tertiary Care Centers/statistics & numerical data , Anticonvulsants/therapeutic use , Brazil/epidemiology , Epilepsy/psychology , Social Security , Socioeconomic Factors , Surveys and Questionnaires , Unemployment/statistics & numerical dataABSTRACT
OBJECTIVE: To evaluate sleep characteristics verifying for the presence of depressive symptoms in mothers of insomniac children living in São Paulo (Brazil) and Barcelona (Spain). METHOD: Forty-six mothers were evaluated, 37 from São Paulo and nine from Barcelona, their ages varying from 19 to 44, and their children; otherwise healthy but with complaints of insomnia, their age varying from three to 33 months. The mothers' sleep quality was rated by the Pittsburgh Sleep Quality Index (PSQI), and the Beck Depression Inventory (BDI). RESULTS: 91.30% of mothers reported poor sleep by PSQI standards. Regarding signs and symptoms of depression, 69.56% of all mothers in this sample showed them. Direct correlation between São Paulo mothers PSQI and BDI was found and also between the child's age and BDI. CONCLUSION: The mothers' poor sleep was related to mood changes with symptoms of depression presenting similar results in both cities.
Subject(s)
Depression/psychology , Mood Disorders/psychology , Mothers/psychology , Sleep Initiation and Maintenance Disorders/psychology , Sleep/physiology , Adult , Age Distribution , Age Factors , Brazil , Child, Preschool , Depression/complications , Female , Humans , Infant , Male , Mood Disorders/complications , Psychiatric Status Rating Scales , Sleep Initiation and Maintenance Disorders/classification , Sleep Initiation and Maintenance Disorders/etiology , Spain , Statistics, Nonparametric , Young AdultABSTRACT
O presente trabalho se propõe a descrever as condições do idoso no Brasil, abordando os aspectos biopsicossociais do envelhecer. Os autores pretendem relatar sua experiência a partir do diagnóstico institucional realizado pelo grupo que resultou em propostas de trabalho a serem desenvolvidas. O enfoque será o grupo terapêutico com idosos. Tem como principal objetivo resgatar a identidade, as capacidades até então adormecidas e promover a interação através da troca de idéias, estórias de vida, pensamentos e sentimentos. Para concluir percebe-se que, mesmo com as limitações do envelhecimento a grupoterapia é possível e viável desde que se tenha uma flexibilidade da técnica que permita atingir os objetivos a que se propõe o trabalho (AU)
Subject(s)
Aged , Humans , Male , Female , Psychotherapy, Group , Quality of Life , Homes for the AgedABSTRACT
O presente trabalho se propõe a descrever as condições do idoso no Brasil, abordando os aspectos biopsicossociais do envelhecer. Os autores pretendem relatar sua experiência a partir do diagnóstico institucional realizado pelo grupo que resultou em propostas de trabalho a serem desenvolvidas. O enfoque será o grupo terapêutico com idosos. Tem como principal objetivo resgatar a identidade, as capacidades até então adormecidas e promover a interação através da troca de idéias, estórias de vida, pensamentos e sentimentos. Para concluir percebe-se que, mesmo com as limitações do envelhecimento a grupoterapia é possível e viável desde que se tenha uma flexibilidade da técnica que permita atingir os objetivos a que se propõe o trabalho.
Subject(s)
Humans , Male , Female , Aged , Homes for the Aged , Psychotherapy, Group , Quality of LifeABSTRACT
Neste trabalho faz-se uma reflexão sobre idosos institucionalizados através das vivências psicológicas em grupos terapêuticos. Percebe-se, com a vivência grupal, que a condição interna dessas pessoas está, muitas vezes, associadas às regras da instituição, sentimentos de abandono, dificuldade em lidar com a sexualidade e a proximidade da morte. Isto forma uma barreira entre os idosos e o mundo externo que favorece a mortificação do eu. Pretende-se resgatar, através deste trabalho, a identidade do idoso com a promoção da interação entre os mesmos (AU)
Subject(s)
Aged , Aged , Psychotherapy, Group , Self-Help Groups , Homes for the Aged , Identity CrisisABSTRACT
Neste trabalho faz-se uma reflexão sobre idosos institucionalizados através das vivências psicológicas em grupos terapêuticos. Percebe-se, com a vivência grupal, que a condição interna dessas pessoas está, muitas vezes, associadas às regras da instituição, sentimentos de abandono, dificuldade em lidar com a sexualidade e a proximidade da morte. Isto forma uma barreira entre os idosos e o mundo externo que favorece a mortificação do eu. Pretende-se resgatar, através deste trabalho, a identidade do idoso com a promoção da interação entre os mesmos
