title: The effect of recurrent seizures on cognitive, behavioral, and quality-of-life outcomes after 12 months of monotherapy in adults with newly diagnosed or previously untreated partial epilepsy.
abstract: OBJECTIVE
  The purpose of this study was to determine whether seizure recurrence has a negative impact on cognition, psychological function, and health-related quality of life (HRQoL) over a 12-month period of monotherapy in adults with newly diagnosed or previously untreated partial epilepsy.
  
  
  METHODS
  Seizure freedom (SF) was defined as no seizure recurrence during the 40-week maintenance period of medication. Neuropsychological tests, the Symptom Checklist-90 (SCL-90), and the Quality of Life in Epilepsy-31 (QOLIE-31) were administered at baseline and after 48 weeks of carbamazepine or lamotrigine monotherapy. Seventy-three patients successfully continued treatment until the 48-week follow-up time point. Fifty patients (68.5%) had SF, and the remaining 23 were not seizure-free (NSF). A seizure outcome group-by-time interaction was analyzed using a linear mixed model.
  
  
  RESULTS
  A group-by-time interaction was identified for the total QOLIE-31 score (p<0.05) and score on two QOLIE-31 subscales (social function: p<0.001 and seizure worry: p<0.001), with a significant improvement over time only present in the SF group (all p<0.001). There was no significant group-by-time interaction for most cognitive function tests, with the exception of the serial clustering score (p<0.01) and number of recognition hits on the California Verbal Learning Test (p<0.05). Serial clustering did not differ between the SF and NSF groups at baseline, but was significantly more used in the NSF group than in the SF group at 48 weeks (p<0.01). There was no significant group-by-time interaction for any dimension of the SCL-90.
  
  
  CONCLUSIONS
  Recurrent seizures had a significant effect on HRQoL, a subtle effect on cognitive performance, and no effect on psychological symptoms over one year in newly diagnosed or previously untreated adults with partial epilepsy.
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea. Electronic address: salee@amc.seoul.kr.
authors.forename: Sang-Ahm
authors.initials: SA
authors.lastname: Lee
authors.affiliation: Department of Neurology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Republic of Korea.
authors.forename: Min Ju
authors.initials: MJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Ewha Womans University, College of Medicine, Seoul, Republic of Korea.
authors.forename: Hyang-Woon
authors.initials: HW
authors.lastname: Lee
authors.affiliation: Department of Neurology, Yonsei University Medical School, Seoul, Republic of Korea.
authors.forename: Kyoung
authors.initials: K
authors.lastname: Heo
authors.affiliation: Department of Neurology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
authors.forename: Dong-Jin
authors.initials: DJ
authors.lastname: Shin
authors.affiliation: Department of Neurology, Hallym University Institute of Epilepsy Research, Seoul, Republic of Korea.
authors.forename: Hong-Ki
authors.initials: HK
authors.lastname: Song
authors.affiliation: Department of Neurology, CHA University School of Medicine, Sungnam, Republic of Korea.
authors.forename: Ok-Joon
authors.initials: OJ
authors.lastname: Kim
authors.affiliation: Division of Biostatistics, Center for Medical Research and Information, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Seon-Ok
authors.initials: SO
authors.lastname: Kim
authors.affiliation: Department of Neurology, Yonsei University Medical School, Seoul, Republic of Korea.
authors.forename: Byung-In
authors.initials: BI
authors.lastname: Lee
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use*; D002220:Carbamazepine / Q000494:pharmacology / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000077213:Lamotrigine; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012008:Recurrence; D012640:Seizures / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology*; D016896:Treatment Outcome; D014227:Triazines / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014227:Triazines; D002220:Carbamazepine; D000077213:Lamotrigine
keywords: Behavior; Cognition; Epilepsy; Newly diagnosed; Quality of life