Reduction in apathy following epilepsy surgery

Linda Mah,1–3 Joan Swearer,4 Catherine A Phillips,4 Sheldon Benjamin51Rotman Research Institute, Baycrest, Toronto, Canada; 2Department of Psychiatry, Baycrest Health Sciences, Toronto, Canada; 3Department of Psychiatry, Division of Geriatric Psychiatry, University of Toronto, Toronto, Can...

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Autores principales:	Mah L, Swearer J, Phillips CA, Benjamin S
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	epilepsy surgery apathy frontal lobe disinhibition motivation temporal lobe epilepsy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/3878dec1dc4e4baaac75c76d51f48996
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spelling	oai:doaj.org-article:3878dec1dc4e4baaac75c76d51f489962021-12-02T05:51:09ZReduction in apathy following epilepsy surgery1178-2021https://doaj.org/article/3878dec1dc4e4baaac75c76d51f489962019-06-01T00:00:00Zhttps://www.dovepress.com/reduction-in-apathy-following-epilepsy-surgery-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Linda Mah,1–3 Joan Swearer,4 Catherine A Phillips,4 Sheldon Benjamin51Rotman Research Institute, Baycrest, Toronto, Canada; 2Department of Psychiatry, Baycrest Health Sciences, Toronto, Canada; 3Department of Psychiatry, Division of Geriatric Psychiatry, University of Toronto, Toronto, Canada; 4Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA; 5Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USAIntroduction: Surgical treatment for patients with epilepsy who do not respond to antiepileptic medication can lead to changes in behavior, including new onset of neuropsychiatric symptoms such as depression and anxiety. In other cases, neuropsychiatric symptoms present before surgery may be alleviated. Because application of diagnostic criteria for primary psychiatric disorders may not be valid in assessing behavior in epilepsy populations, we sought to determine the feasibility of measuring behaviors associated with frontal-subcortical dysfunction using the Frontal Systems Behavior Scale (FrSBe) in patients who had received surgical intervention for medically refractory epilepsy.Materials and methods: Twenty-three patients who had previously undergone epilepsy surgery and their family member informants completed the FrSBe. The FrSBe includes separate forms for patients and informants to rate symptoms associated with three frontal lobe syndromes – executive dysfunction, disinhibition, and apathy – prior to and following a neurological condition. Patients and informants were asked to rate frontal lobe behaviors before and after epilepsy surgery using the FrSBe.Results: Informants rated patients as showing a significantly greater reduction in apathy on the FrSBe compared to either disinhibition or executive dysfunction subscales. A trend in reduction of apathy following right hemisphere resection was found.Conclusions: Patients who have undergone epilepsy surgery show a reduction in apathy but it is unclear whether this behavioral change is directly related to the surgical intervention. We suggest that these preliminary findings support the utility of implementing dimensional scales such as the FrSBe to study behavioral changes following epilepsy surgery.Keywords: epilepsy surgery, apathy, frontal lobe, disinhibition, motivation, temporal lobe epilepsyMah LSwearer JPhillips CABenjamin SDove Medical Pressarticleepilepsy surgeryapathyfrontal lobedisinhibitionmotivationtemporal lobe epilepsyNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 15, Pp 1679-1684 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	epilepsy surgery apathy frontal lobe disinhibition motivation temporal lobe epilepsy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	epilepsy surgery apathy frontal lobe disinhibition motivation temporal lobe epilepsy Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Mah L Swearer J Phillips CA Benjamin S Reduction in apathy following epilepsy surgery
description	Linda Mah,1–3 Joan Swearer,4 Catherine A Phillips,4 Sheldon Benjamin51Rotman Research Institute, Baycrest, Toronto, Canada; 2Department of Psychiatry, Baycrest Health Sciences, Toronto, Canada; 3Department of Psychiatry, Division of Geriatric Psychiatry, University of Toronto, Toronto, Canada; 4Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA; 5Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USAIntroduction: Surgical treatment for patients with epilepsy who do not respond to antiepileptic medication can lead to changes in behavior, including new onset of neuropsychiatric symptoms such as depression and anxiety. In other cases, neuropsychiatric symptoms present before surgery may be alleviated. Because application of diagnostic criteria for primary psychiatric disorders may not be valid in assessing behavior in epilepsy populations, we sought to determine the feasibility of measuring behaviors associated with frontal-subcortical dysfunction using the Frontal Systems Behavior Scale (FrSBe) in patients who had received surgical intervention for medically refractory epilepsy.Materials and methods: Twenty-three patients who had previously undergone epilepsy surgery and their family member informants completed the FrSBe. The FrSBe includes separate forms for patients and informants to rate symptoms associated with three frontal lobe syndromes – executive dysfunction, disinhibition, and apathy – prior to and following a neurological condition. Patients and informants were asked to rate frontal lobe behaviors before and after epilepsy surgery using the FrSBe.Results: Informants rated patients as showing a significantly greater reduction in apathy on the FrSBe compared to either disinhibition or executive dysfunction subscales. A trend in reduction of apathy following right hemisphere resection was found.Conclusions: Patients who have undergone epilepsy surgery show a reduction in apathy but it is unclear whether this behavioral change is directly related to the surgical intervention. We suggest that these preliminary findings support the utility of implementing dimensional scales such as the FrSBe to study behavioral changes following epilepsy surgery.Keywords: epilepsy surgery, apathy, frontal lobe, disinhibition, motivation, temporal lobe epilepsy
format	article
author	Mah L Swearer J Phillips CA Benjamin S
author_facet	Mah L Swearer J Phillips CA Benjamin S
author_sort	Mah L
title	Reduction in apathy following epilepsy surgery
title_short	Reduction in apathy following epilepsy surgery
title_full	Reduction in apathy following epilepsy surgery
title_fullStr	Reduction in apathy following epilepsy surgery
title_full_unstemmed	Reduction in apathy following epilepsy surgery
title_sort	reduction in apathy following epilepsy surgery
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/3878dec1dc4e4baaac75c76d51f48996
work_keys_str_mv	AT mahl reductioninapathyfollowingepilepsysurgery AT swearerj reductioninapathyfollowingepilepsysurgery AT phillipsca reductioninapathyfollowingepilepsysurgery AT benjamins reductioninapathyfollowingepilepsysurgery
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Reduction in apathy following epilepsy surgery

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