Christine Doherty1, Amy S Nowacki2, Mary Pat McAndrews3,4, Carrie R McDonald5, Anny Reyes5, Michelle S Kim6, Marla Hamberger7, Imad Najm8,9, William Bingaman8, Lara Jehi8, Robyn M Busch8,9. 1. Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH, USA. 2. Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. 3. Department of Psychology, University of Toronto, Toronto, ON, Canada. 4. Krembil Brain Institute, University Health Network, Toronto, ON, Canada. 5. Department of Psychiatry, University of California, San Diego, San Diego, CA, USA. 6. Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA. 7. Department of Neurology, Columbia University, New York, New York, USA. 8. Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA. 9. Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Abstract
OBJECTIVE: To develop a model to predict the probability of mood decline in adults following temporal lobe resection for the treatment of pharmacoresistant epilepsy. METHODS: Variable selection was performed on 492 patients from the Cleveland Clinic using best subsets regression. After completing variable selection, a subset of variables was requested from four epilepsy surgery centers across North America (n = 100). All data were combined to develop a final model to predict postoperative mood decline (N = 592). Internal validation with bootstrap resampling was performed. A clinically significant increase in depressive symptoms was defined as a 15% increase in Beck Depression Inventory-Second Edition score and a postoperative raw score > 11. RESULTS: Fourteen percent of patients in the Cleveland Clinic cohort and 22% of patients in the external cohort experienced clinically significant increases in depressive symptoms following surgery. The final prediction model included six predictor variables: psychiatric history, resection side, relationship status, verbal fluency score, age at preoperative testing, and presence/absence of malformation of cortical development on magnetic resonance imaging. The model had an optimism-adjusted c-statistic of .70 and good calibration, with slight probability overestimation in higher risk patients. SIGNIFICANCE: Clinicians can utilize our nomogram via a paper tool or online calculator to estimate the risk of postoperative mood decline for individual patients prior to temporal lobe epilepsy surgery.
OBJECTIVE: To develop a model to predict the probability of mood decline in adults following temporal lobe resection for the treatment of pharmacoresistant epilepsy. METHODS: Variable selection was performed on 492 patients from the Cleveland Clinic using best subsets regression. After completing variable selection, a subset of variables was requested from four epilepsy surgery centers across North America (n = 100). All data were combined to develop a final model to predict postoperative mood decline (N = 592). Internal validation with bootstrap resampling was performed. A clinically significant increase in depressive symptoms was defined as a 15% increase in Beck Depression Inventory-Second Edition score and a postoperative raw score > 11. RESULTS: Fourteen percent of patients in the Cleveland Clinic cohort and 22% of patients in the external cohort experienced clinically significant increases in depressive symptoms following surgery. The final prediction model included six predictor variables: psychiatric history, resection side, relationship status, verbal fluency score, age at preoperative testing, and presence/absence of malformation of cortical development on magnetic resonance imaging. The model had an optimism-adjusted c-statistic of .70 and good calibration, with slight probability overestimation in higher risk patients. SIGNIFICANCE: Clinicians can utilize our nomogram via a paper tool or online calculator to estimate the risk of postoperative mood decline for individual patients prior to temporal lobe epilepsy surgery.
Authors: Robyn M Busch; Olivia Hogue; Michael W Kattan; Marla Hamberger; Daniel L Drane; Bruce Hermann; Michelle Kim; Lisa Ferguson; William Bingaman; Jorge Gonzalez-Martinez; Imad M Najm; Lara Jehi Journal: Neurology Date: 2018-11-07 Impact factor: 9.910
Authors: Zachary Fitzgerald; Marcia Morita-Sherman; Olivia Hogue; Boney Joseph; Marina K M Alvim; Clarissa L Yasuda; Deborah Vegh; Dileep Nair; Richard Burgess; William Bingaman; Imad Najm; Michael W Kattan; Ingmar Blumcke; Gregory Worrell; Benjamin H Brinkmann; Fernando Cendes; Lara Jehi Journal: Epilepsia Date: 2021-08-02 Impact factor: 6.740
Authors: Christine Doherty; Amy S Nowacki; Mary Pat McAndrews; Carrie R McDonald; Anny Reyes; Michelle S Kim; Marla Hamberger; Imad Najm; William Bingaman; Lara Jehi; Robyn M Busch Journal: Epilepsia Date: 2021-03-15 Impact factor: 6.740