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. 2021 Jun;6(2):369-380.
doi: 10.1002/epi4.12488. Epub 2021 May 5.

Behavioral phenotypes of temporal lobe epilepsy

Bruce P Hermann  1 , Aaron F Struck  1   2 , Kevin Dabbs  1 , Mike Seidenberg  3 , Jana E Jones  1
Affiliations

Behavioral phenotypes of temporal lobe epilepsy

Bruce P Hermann et al. Epilepsia Open. 2021 Jun.

Abstract

Objective: To identity phenotypes of self-reported symptoms of psychopathology and their correlates in patients with temporal lobe epilepsy (TLE).

Method: 96 patients with TLE and 82 controls were administered the Symptom Checklist 90-Revised (SCL-90-R) to characterize emotional-behavioral status. The nine symptom scales of the SCL-90-R were analyzed by unsupervised machine learning techniques to identify latent TLE groups. Identified clusters were contrasted to controls to characterize their association with sociodemographic, clinical epilepsy, neuropsychological, psychiatric, and neuroimaging factors.

Results: TLE patients as a group exhibited significantly higher (abnormal) scores across all SCL-90-R scales compared to controls. However, cluster analysis identified three latent groups: (1) unimpaired with no scale elevations compared to controls (Cluster 1, 42% of TLE patients), (2) mild-to-moderate symptomatology characterized by significant elevations across several SCL-90-R scales compared to controls (Cluster 2, 35% of TLE patients), and (3) marked symptomatology with significant elevations across all scales compared to controls and the other TLE phenotype groups (Cluster 3, 23% of TLE patients). There were significant associations between cluster membership and demographic (education), clinical epilepsy (perceived seizure severity, bitemporal lobe seizure onset), and neuropsychological status (intelligence, memory, executive function), but with minimal structural neuroimaging correlates. Concurrent validity of the behavioral phenotype grouping was demonstrated through association with psychiatric (current and lifetime-to-date DSM IV Axis 1 disorders and current treatment) and quality-of-life variables.

Significance: Symptoms of psychopathology in patients with TLE are characterized by a series of discrete phenotypes with accompanying sociodemographic, cognitive, and clinical correlates. Similar to cognition in TLE, machine learning approaches suggest a developing taxonomy of the comorbidities of epilepsy.

Keywords: behavior; phenotypes; psychopathology; temporal lobe epilepsy.

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Conflict of interest statement

The authors have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

Figures

FIGURE 1
FIGURE 1
Mean SCL‐90‐R Scale Scores for Control and TLE groups. ANX, Anxiety; DEP, Depression; HOS, Hostility; IS, Interpersonal sensitivity; LOC, Obsessive‐compulsive; PAR, Paranoid ideation; PHOB, Phobic anxiety; Som, Somatization
FIGURE 2
FIGURE 2
Control and TLE behavioral phenotype profiles. ANX, Anxiety; DEP, Depression; HOS, Hostility; IS, Interpersonal sensitivity; LOC, Obsessive‐compulsive; PAR, Paranoid ideation; PHOB, Phobic anxiety; Som, Somatization
See this image and copyright information in PMC

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