Responsive neurostimulation in Epilepsy: Effects on mood and quality of life

Objective: Epilepsy affects over 3.4 million individuals in the U.S. and significantly impacts well- being. For drug-resistant epilepsy (DRE), RNS offers a nonpharmacological intervention to reduce seizures. This study examined the impact of RNS on self-reported depressive symptoms and quality of life (QoL) in 33 patients (48.5 % female, mean age = 32.88, SD = 13.86) treated at a Level 4 epilepsy center. Methods: Participants completed the Beck Depression Inventory-II (BDI-II) and the Quality of Life in Epilepsy Inventory-31 (QOLIE-31) after RNS implantation. A subset of participants had available information for pre- and post-RNS assessments. Statistical analyses were conducted using SPSS software. Results: After RNS implantation, most participants reported minimal depressive symptoms (72.4 %) and average or above-average QoL, particularly in emotional well-being. Despite no significant changes in the overall QOLIE-31 scores, a subset of participants with pre- and post- data showed trends toward improved social functioning, energy levels, and medication effects. This group reported perceived improvements in cognitive functioning (M = 63.35, SD = 22.96). Strong positive Pearson correlations were found among QOLIE-31 domain scores, including social functioning, cognitive functioning, energy levels, emotional well-being, and overall QoL. Higher levels of depression correlated with poorer outcomes in QOLIE-31 domains. Time since RNS implantation positively correlated with depressive symptoms. No significant correlation was found between seizure improvement and mood or QoL outcomes. Conclusions: Findings highlight the importance of continued mood monitoring and tailored interventions in DRE patients receiving RNS treatment. Further longitudinal and diverse studies are needed to fully understand the long-term psychological impact of RNS.