Quality of life self-assessment as a function of lateralization of lesion in candidates for epilepsy surgery

Purpose: This prospective study aimed to investigate the relationship(s) of the laterality of the epileptogenic lesion to personality factors, emotional processing, and the subjective experience of quality-of-life (QOL) self-assessment in candidates for epilepsy surgery. Methods: Patients who were candidates for epilepsy surgery were studied. Eighteen of them (aged 19-61 years) had localization-related epilepsy in the right temporal lobe (RTLE), 18 (aged 21-50 years) had localization-related epilepsy in the left temporal robe (LTLE), and 20 were demographically matched normal subjects. The Spielberger Trait/State Anxiety questionnaire and the QOLIE-31 questionnaire for self-assessment of quality of lift: were used. One-way analysis of variance, Pearson correlations, and linear regression analysts were performed on group and anxiety levels and QOLIE variables. Results: LTLE patients systematically showed higher levels of anxiety and lower self-estimates of the quality of their lives when compared with RTLE patients. All anxiety measures were highly correlated with Total QOL in LTLE (p < 0.05) but not in RTLE patients; however, different parameters of QOL showed different relationships with measures of anxiety. Results of multiple regression analyses suggested that the level of anxiety was relatively stable and less affected by QOL factors in LTLE as compared with RTLE patients (p = 0.03). Conclusions: A high level of anxiety shown by LTLE patients may represent a personality trait and cause a response bias in overreporting of negative symptoms and a decreased self-assessment of QOL. It may also present a presurgical risk factor, particularly for patients with LTLE lesions. Appropriate patient counseling is advised.