Cognition in persons with epilepsy dependent on type, therapy model

CHICAGO – For persons with epilepsy, cognitive impairment was reduced for those with the generalized form of the disease, as well as for those who are prescribed more than one type of therapy, according to a poster at ANA 2022.

“The goal is to find adverse effects that most commonly affect patients related to cognition, because patients with epilepsy might have controlled seizures, but if the adverse effects are so much that they affect quality of life, we need to address those issues as well,” Fahham Asghar, MD, research fellow in the department of neurology, College of Medicine and Life Sciences at the University of Toledo, told Healio.

Asghar and colleagues aimed to ascertain the levels of neurocognitive function for persons with epilepsy using the Repeatable Battery for Assessment of Neuropsychological Status (RBANS), a self-administered set of 12 tasks whose results yield index scores for five different cognitive domains: attention, language, visuospatial/construction, immediate memory and delayed memory.

Researchers conducted a cross-sectional study that included 79 individuals (66% female) diagnosed with epilepsy from the University of Toledo’s Epilepsy Clinic, who were given the RBANS. Scores on the test are based on a mean of 100 with a standard deviation of 15, and were stratified to account for patient demographics, details of disease and method of treatment.

Results showed that persons with epilepsy performed lower across all RBANS indices compared with those without (language: 90.4 ± 15.2; visuospatial/construction: 87.8 ± 18.5; immediate memory: 86.4 ± 17; delayed memory: 85.3 ± 20.4; attention 83.1 ± 21.1)

Data additionally revealed that participants with focal epilepsy posted higher RBANS scores than those with generalized epilepsy, and individuals guided by monotherapy posted higher scores compared with those on polytherapy.

“In the longer term, we will target multiple medications and see which ones have the lowest adverse effects,” Asghar told Healio. “Based upon the patient’s profile, we will target those medications, apply counseling to find out how long-term therapy would (fare in this patient population.)”