Which clinical and neuropsychological factors are responsible for cognitive impairment in patients with epilepsy?

  • PDF / 481,024 Bytes
  • 10 Pages / 595.276 x 790.866 pts Page_size
  • 25 Downloads / 156 Views

DOWNLOAD

REPORT


(0123456789().,-volV)(0123456789(). ,- volV)

ORIGINAL ARTICLE

Which clinical and neuropsychological factors are responsible for cognitive impairment in patients with epilepsy? Dominika Jarcˇusˇkova´1,2,3 • Miroslava Palusˇna´1,4 • Jakub Gazda3,5 • Eva Feketeova´1,3



Zuzana Gdovinova´1,3

Received: 20 November 2019 / Revised: 26 May 2020 / Accepted: 27 May 2020  Swiss School of Public Health (SSPH+) 2020

Abstract Objectives The study aimed to assess the effect of demographic and clinical features of epilepsy, anxiety, depressed mood, sleep, and quality of life on the prediction of cognitive decline in patients with epilepsy. Methods Two hundred and six consecutive patients with epilepsy (age 41.8 ± 15.6 years, mean, SD) out of 279, were included in this cross-sectional study. We used simple linear regression to calculate the results. Results Objective cognitive status was predicted by anxiety and depression mood changes (Beck Anxiety Inventory (BAI), p = 0.03, Beck Depression Inventory (BDI), p = 0.005), language subdomain of Quality of Life Inventory in Epilepsy-89 (QOLIE-89) (p = 0.003), and total QOLIE-89 (p = 0.001). No significance was shown in demographic and clinical features of epilepsy (gender, age at onset, epilepsy duration, type, etiology of epilepsy, and antiepileptic treatment), except frequency of generalized epileptic seizures (p = 0.03), which also served as an independent predictor of anxiety (BAI) and depression (BDI). Conclusions Our findings point at the role of mood changes in the cognitive status of patients with epilepsy, which should be used as an essential therapeutic target apart of seizure control. Keywords Cognition  Epilepsy  EpiTrack  Cognitive impairment  Depression  Anxiety

Introduction & Eva Feketeova´ [email protected] Dominika Jarcˇusˇkova´ [email protected] Miroslava Palusˇna´ [email protected] Jakub Gazda [email protected] Zuzana Gdovinova´ [email protected] 1

Department of Neurology, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia

2

1st Department of Psychiatry, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia

3

University Hospital of L. Pasteur Kosice, Tr. SNP 1, 04011 Kosice, Slovakia

4

Department of Psychiatry, Faculty Hospital of J.A. Reiman, Presˇov, Slovakia

5

1st Department of Internal Medicine, Faculty of Medicine, P. J. Safarik University, Trieda SNP 1, 040 11 Kosice, Slovakia

The risk of cognitive decline caused by epilepsy was first described more than 100 years ago (Wallin 1912). The dominant model of cognitive impairment in epilepsy emphasizes structural bases for cognitive deficits (Dodson and Pellock 1993). Morphological factors refer to the presence of developmental or acquired cerebral lesions causing both epilepsy and cognitive impairment. Current theories point at the importance of disturbed network interactions as a pathophysiological basis of cognitive dysfunction in patients with epilepsy (PWE) (Tailby et al. 2018). Dynamic factors are epileptic s