Epilepsia · 2026
Depressive symptoms as independent correlates of epilepsy-related cognitive burden.
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Sancetta Biagio Maria, Lippa Giuli, Nesta Marianna, Ricci Lorenzo, Carbone Simona Paola, Veronese Lorenzo, Conti Giulia, Sferruzzi Marco, Di Lazzaro Vincenzo, Tombini Mario, Assenza Giovanni
Аннотация
OBJECTIVE: This study was undertaken to assess the relationship between the severity of depression and anxiety symptoms and epilepsy-related variables and cognitive burden in people with epilepsy (PwE), as assessed using EpiTrack.
METHODS: We prospectively enrolled a cohort of PwE who underwent EpiTrack and evaluation by Generalized Anxiety Disorder-7 (GAD-7) and Beck Depression Inventory-II (BDI-II) scales. We assessed the correlation strength between EpiTrack, GAD-7, BDI-II, and the other clinical variables. Analysis of variance and covariance assessed the existence of GAD-7/BDI-II differences between PwE with and without epilepsy-related cognitive impairment. Hierarchical regression analysis (HRA) and logistic regression were performed to characterize the association between BDI-II and GAD-7 and the presence/severity of epilepsy-related cognitive burden. Mediation analysis was performed to evaluate the relationship between EpiTrack and the other variables applied.
RESULTS: We enrolled 100 PwE (42 ± 18 years old). EpiTrack inversely correlated with BDI-II (-.33, p = .003, not with GAD-7), seizures (-.34, p < .001), epileptiform abnormalities (34, p < .001), and pharmacological burden (.21, p = .002). BDI-II correlated with seizure frequency (.27, p = .02). PwE with cognitive impairment had significantly higher BDI-II scores, independently of age, seizure frequency, epileptiform abnormalities, and pharmacological load (p = .02-.04). BDI-II effect on EpiTrack was independent from seizures. The addition of BDI-II in HRA and logistic regression provided a significant increase of the R2 value (p = .004) and of area under the curve (p = .02).
SIGNIFICANCE: More severe depressive symptoms are strongly associated with worse cognitive performance in PwE, independently of the other epilepsy-related variables. Depressive symptoms could either forecast the occurrence of epilepsy-related cognitive impairment or arise as a consequence of cognitive dysfunction in PwE. We confirmed the association between epilepsy severity and epilepsy-related cognitive impairment.
METHODS: We prospectively enrolled a cohort of PwE who underwent EpiTrack and evaluation by Generalized Anxiety Disorder-7 (GAD-7) and Beck Depression Inventory-II (BDI-II) scales. We assessed the correlation strength between EpiTrack, GAD-7, BDI-II, and the other clinical variables. Analysis of variance and covariance assessed the existence of GAD-7/BDI-II differences between PwE with and without epilepsy-related cognitive impairment. Hierarchical regression analysis (HRA) and logistic regression were performed to characterize the association between BDI-II and GAD-7 and the presence/severity of epilepsy-related cognitive burden. Mediation analysis was performed to evaluate the relationship between EpiTrack and the other variables applied.
RESULTS: We enrolled 100 PwE (42 ± 18 years old). EpiTrack inversely correlated with BDI-II (-.33, p = .003, not with GAD-7), seizures (-.34, p < .001), epileptiform abnormalities (34, p < .001), and pharmacological burden (.21, p = .002). BDI-II correlated with seizure frequency (.27, p = .02). PwE with cognitive impairment had significantly higher BDI-II scores, independently of age, seizure frequency, epileptiform abnormalities, and pharmacological load (p = .02-.04). BDI-II effect on EpiTrack was independent from seizures. The addition of BDI-II in HRA and logistic regression provided a significant increase of the R2 value (p = .004) and of area under the curve (p = .02).
SIGNIFICANCE: More severe depressive symptoms are strongly associated with worse cognitive performance in PwE, independently of the other epilepsy-related variables. Depressive symptoms could either forecast the occurrence of epilepsy-related cognitive impairment or arise as a consequence of cognitive dysfunction in PwE. We confirmed the association between epilepsy severity and epilepsy-related cognitive impairment.