The impact of brain structures and sensory profiles on treatment resistance adult epilepsy

The aim of our study was to examine the relationship between the sensory processing profiles of adult epilepsy patients and their response to drug treatment. The study included adults aged 18-65 years who were admitted to the Department of Neurology at Bezmialem Vakif University Hospital. Participants were divided into three groups: those with Drug-resistant epilepsy (DRE), those with drug responded epilepsy, and a healthy control (HC) group. Demographic data, epilepsy history, and brain magnetic resonance imaging (MRI) findings were recorded. Sensory processing profiles were measured using the Adolescent/Adult Dunn Sensory Profile (ASDP), and quality of life was measured using the Quality of Life in Epilepsy Scale (QOLIE-31). The obtained data were statistically analyzed using SPSS 27 software. The number of participants was 30 in the DRE group, 28 in the IYE group, and 28 in the SK group. The mean ages were 34.40±11.55 in the IDE group, 34.28±8.79 in the drug responded epilepsy group, and 33.85±8.39 in the HC group. The average duration of epilepsy diagnosis was 14.46±9.67 years (1–40 years) in the DRE group and 14.96±10.94 years (2–48 years) in the drug responded epilepsy group. Statistically significant differences were found between the groups in the "Sensory Avoidance" and "Sensory Registration" subscales of the participants' sensory profiles (p<0.05). In the Sensory Avoidance dimension, the number of individuals showing atypical levels of sensory avoidance in the epilepsy group was 46 (79.3%), while in the HC, the number of individuals was only 10 (35.7%). In the Sensory Registration dimension, 50% of individuals with epilepsy had an atypical profile, while only 17.9% of healthy individuals had an atypical level. In Sensory Avoidance, an atypical profile was observed in 78.6% of the Idiopathic Generalized Epilepsy (IGE) group and 80.0% of the Focal Epilepsy (FE) group, while this rate was found to be 35.7% in the HC. Statistically significant differences were found between the DRE and drug responded epilepsy groups in terms of cognitive function, social functioning, total score, and health status subdimensions (p<0.05). Significant differences were found between epilepsy types in terms of seizure anxiety (p=0.028), medication effects (p=0.003), and total score (p=0.018) (p<0.05). Individuals diagnosed with FE had lower quality of life scores in these subdimensions compared to those diagnosed with IGE. This study revealed that different types of epilepsy and responses to treatment significantly affect quality of life and sensory processing profiles in adults with epilepsy. Atypical profiles in 'sensory avoidance' and 'sensory registration' were found to be more prevalent in drug-resistant patients, who experienced losses in cognitive function, social participation, and general health perception. Individuals with focal epilepsy in particular were found to have a lower quality of life due to seizure anxiety and the effects of medication. This study shows that, when evaluating individuals with epilepsy, not only seizure control, but also sensory integration and neuropsychological functions should be taken into consideration, and that a multidisciplinary approach to treatment can significantly improve quality of life.