UNRAVELING THE LINK BETWEEN EPILEPTIC FOCUS LATERALIZATION AND DEPRESSION IN FOCAL EPILEPSY.

Abstract

Background and aim: Focal epilepsy frequently coexists with anxiety and depressive disorders, which can undermine treatment adherence and worsen seizure control. We aimed to compare the psycho-emotional profiles of patients with left- versus right-hemispheric focal epilepsy and assess how focus lateralization relates to depressive, anxiety, somatic and speech parameters to inform personalized diagnosis and therapy.

Materials and methods: Sixty patients with focal epilepsy were divided into left- and right-hemispheric groups (n = 30 each). Psycho-emotional state was rated by three experts using the Hamilton Depression Rating Scale (HAM-D), State-Trait Anxiety Inventory (STAI), Patient Health Questionnaire-15 (PHQ-15), Emotional Reactivity Index (ERI) and a DSM-5-based awareness scale; speech productivity was scored on a 0-10 scale. Group comparisons used Student's t-test or Mann-Whitney U test after Shapiro-Wilk normality check; p<0.05 was considered significant.

Results: Significant differences were observed between left- and right-hemispheric patients across all measures (p<0.001; Cohen's d>2.8). Left-hemispheric epilepsy featured higher apathy/anhedonia (HAM-D: 7.5±1.2; 76.6%≥8), greater self-awareness (9.0±0.8) and preserved speech productivity (7.0±1.3). Right-hemispheric epilepsy exhibited elevated anxiety (STAI: 9.0±1.0; 83.3% high), somatization (PHQ-15: 7.0±1.5; 71%≥10), emotional lability (ERI: 8.0±1.2) and reduced awareness (4.0±1.6) and speech productivity (2.0±1.1).

Conclusion: Epileptic focus lateralization markedly influences affective and speech profiles in focal epilepsy. Recognizing these patterns supports tailored psychopharmacological and psychotherapeutic strategies for left- versus right-hemispheric cases.