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

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.

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.

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).

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.