Quality of life research in adults with epilepsy in Japan

EEG correlates of quality of life and associations with seizure without awareness and depression in patients with epilepsy

Aims

Quality of life (QOL) is an important issue for not only patients with epilepsy but also physicians. Depression has a large impact on QOL. Nonlinear electroencephalogram (EEG) analysis using machine learning (ML) has the potential to improve the accuracy of the diagnosis of epilepsy. Therefore, in this study, we examined EEG nonlinearity, EEG correlates of QOL in patients with epilepsy, and the accuracy of EEG for the interval from seizure without awareness (SA–) and for depression, using ML.

Methods

The Side Effects and Life Satisfaction (SEALS) inventory was used to assess QOL, and the Neurological Disorders Depression Inventory for Epilepsy (NDDI‐E) was used as a screening tool for depression on the date of the EEG recording. EEG with wavelet denoising (WD), the Savitzky–Golay filter, and non‐denoising were created in combination with low‐ and high‐pass filters. These EEG sets were adopted for phase space reconstruction methods. Using a generalized linear mixed‐effects model for SEALS, sample entropy as a measurement of regularity, SA–, seizure with awareness, and depression were examined.

Results

WD and non‐denoising EEG sets in the bilateral posterior temporal‐occipital, centro‐parietal, parieto‐occipital, and Fz–Cz of the 10–20 method were associated with SEALS and demonstrated nonlinearity, and the moderate effects of classification for the interval elapsed from SA– and for depression. When the intervals from SA– were added, the effects of the EEG classification for depression increased.

Conclusion

These findings suggest that EEG regions associated with QOL showing nonlinearity are useful for classifying SA– and depression.

Wavelet denoising and non‐denoising EEG sets in the bilateral posterior temporal‐occipital, centro‐parietal, parieto‐occipital, and Fz‐Cz of the 10‐20 method were associated with the Side Effects and Life Satisfaction inventory and demonstrated nonlinearity, and the moderate effects of classification for the interval elapsed from seizure without awareness and for depression. When the intervals from seizure without awareness were added, the effects of the EEG classification for depression increased.

Neuropsychiatric symptoms, seizure severity, employment, and quality of life of Jordanians with epilepsy

RATIONALE

Depression and anxiety are more strongly associated with quality of life (QOL) than seizure frequency in several populations with epilepsy. However, QOL is culturally determined and may be influenced by cultural values and norms as well as local policies and resources. The goal of this study is to investigate the impact of neuropsychiatric symptoms and seizure severity on QOL and employment in people with epilepsy living in Jordan.

METHODS

Seizure severity and complications, antiepileptic drug side effects, social stigma, neuropsychiatric symptoms, and mental health (MH-SF36) and physical health (PH-SF36) domains of QOL were assessed in 45 adult patients with epilepsy in a university neurology clinic. Multivariate regression analysis was used to evaluate the relationship between these variables and the quality of life of Jordanians with epilepsy.

RESULTS

Neuropsychiatric symptoms, seizure frequency, and history of injury due to seizure were associated with the MH-SF36. However, earlier age of seizure onset, longer duration of epilepsy, unemployment, and history of chronic disease was associated with lower PH-SF36 scores. Furthermore, there were no differences in QOL, neuropsychiatric symptoms, and seizure frequency in Jordanians who were employed versus unemployed in this study.

CONCLUSIONS

Neuropsychiatric symptoms were significantly associated with mental health-related QOL measures, but not with physically-related QOL measures, in Jordanians with epilepsy. For studies across populations, it is critical to separate mental health from physical health QOL measures. Furthermore, regional differences in culture and policy may more strongly influence employment status than individuals' experiences of epilepsy, neuropsychiatric symptoms, or QOL in some populations.

Assessment of health-related quality of life and influencing factors using QOLIE-31 in Japanese patients with epilepsy

The aim of epilepsy treatment is not only to eliminate seizures, but also to improve health-related quality of life (HRQOL). We conducted a postal self-administered survey of HRQOL for Japanese patients using the Quality of Life in Epilepsy inventory (QOLIE-31), Version 1.0, and analyzed factors influencing their quality of life (QOL). Data from 599 analyzable patients were evaluated and a number of factors influencing QOL were identified, including severity and frequency of seizures, seizure control, type of epilepsy, contributing events such as injuries and falls during seizures, number of antiepileptic drugs, employment status, and surgical outcome. These findings suggest that comprehensive management of the patient should be emphasized. Consideration of all the results led to classification of these factors as one of two types: "all or nothing" and "linear." With respect to "all or nothing" factors (e.g. "daytime remarkable seizures"), patients may not be able to improve their QOL unless these factors can be completely controlled. Comparison of each score on the QOLIE-31 subscales with published data revealed that the scores for the subscale Medication Effects were markedly low.

Quality of Life of People with Epilepsy in Iran, the Gulf, and Near East

PURPOSE

To study the impact of epilepsy and its treatment on the quality of life of people living in Iran and in countries in the Gulf and Near East.

METHODS

Clinical, demographic, and psychosocial details were collected through the use of a self-completed questionnaire distributed to patients attending hospital outpatient clinics.

RESULTS

Data were collected from 3,889 people with epilepsy from 10 countries. More than 40% of all respondents had frequent seizures, and reported levels of side effects from medication were high, the most commonly reported being nervousness, headaches, and tiredness. A significant number of respondents reported changing their medications because of side effects or poor seizure control. Respondents reported that epilepsy and its treatment had a significant impact on a number of different aspects of their daily lives. A significant number of respondents felt stigmatized by their epilepsy. Reported health status was reduced when compared with that of people without epilepsy, particularly for physical and social functioning and energy and vitality, as assessed by using a generic health status measure, the SF-36.

CONCLUSIONS

This is the largest study to date documenting the impact of epilepsy and its treatment in Iran, the Gulf, and Near East regions. Differences were found between the quality-of-life profiles of respondents in this study and those who participated in an earlier parallel study in Europe.