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.
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References
Balibey H, Yasar H, Tekeli H, Bayar N (2015) Frequency of anxiety and depression in epileptic patients. Klin Psikofarmakol Bul 25:136–141. https://doi.org/10.5455/bcp.20130429122553
Beaudreau SA, OHara R (2008) Late-life anxiety and cognitive impairment: a review. Am J Geriatr Psychiatry 16:790–803
Beck AT (1961) An inventory for measuring depression. Arch Gen Psychiatry 4:561. https://doi.org/10.1001/archpsyc.1961.01710120031004
Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56:893–897. https://doi.org/10.1037/0022-006X.56.6.893
Breuer LEM, Grevers E, Boon P et al (2017) Cognitive deterioration in adult epilepsy: clinical characteristics of “Accelerated Cognitive Ageing”. Acta Neurol Scand 136:47–53. https://doi.org/10.1111/ane.12700
Buysse DJ, Reynolds CF, Monk TH et al (1989) The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213. https://doi.org/10.1016/0165-1781(89)90047-4
Devinsky O, Vickrey BG, Cramer J et al (1995) Development of the quality of life in epilepsy inventory. Epilepsia 36:1089–1104. https://doi.org/10.1111/j.1528-1157.1995.tb00467.x
Dodson WE, Pellock JM (1993) Pediatric epilepsy: diagnosis and treatment. Demos Publications, New York
Feldman L, Lapin B, Busch RM et al (2018) Evaluating subjective cognitive impairment in the adult epilepsy clinic: effects of depression, number of antiepileptic medications, and seizure frequency. Epilepsy Behavior 81:18–24. https://doi.org/10.1016/j.yebeh.2017.10.011
Fisher PL, Noble AJ (2017) Anxiety and depression in people with epilepsy: the contribution of metacognitive beliefs. Seizure 50:153–159. https://doi.org/10.1016/j.seizure.2017.06.012
Haut SR, Velíšsková J, Moshé SL (2004) Susceptibility of immature and adult brains to seizure effects. Lancet Neurol 3:608–617
Helmstaedter Ch (2015) EpiTrack® test s citlivostí na změny k vyhodnocení kvality a výsledků léčby pacientů s epilepsií, 2nd edn, UCB s.r.o., C.Z
Helmstaedter C, Elger CE (2009) Chronic temporal lobe epilepsy: a neurodevelopmental or progressively dementing disease? Brain 132:2822–2830. https://doi.org/10.1093/brain/awp182
Holmes GL (2015) Cognitive impairment in epilepsy: the role of network abnormalities. Epileptic Disord 17:101–116. https://doi.org/10.1684/epd.2015.0739
Johns MW (1991) A new method for measuring daytime sleepiness: the epworth sleepiness scale. Sleep 14:540–545. https://doi.org/10.1093/sleep/14.6.540
Kaaden S, Quesada CM, Urbach H et al (2011) Neurodevelopmental disruption in early-onset temporal lobe epilepsy: evidence from a voxel-based morphometry study. Epilepsy Behav 20:694–699. https://doi.org/10.1016/j.yebeh.2011.02.020
Kampf C, Walter U, Rösche J (2016) The impact of anxiety, seizure severity, executive dysfunction, subjectively perceived psychological deficits, and depression on social function in patients with epilepsy. Epilepsy Behavior 57:5–8. https://doi.org/10.1016/j.yebeh.2015.10.010
Kleen JK, Scott RC, Lenck-Santini P-P, Holmes GL (2012) Cognitive and behavioral comorbidities of epilepsy. In: Rogawski M, Delgado-Escueta A, Noebels J et al (eds) Jasper’s basic mechanisms of the epilepsies. Oxford University Press, Oxford, pp 915–929
Lukoyanov NV, Sá MJ, Madeira MD, Paula-Barbosa MM (2004) Selective loss of hilar neurons and impairment of initial learning in rats after repeated administration of electroconvulsive shock seizures. Exp Brain Res 154:192–200. https://doi.org/10.1007/s00221-003-1658-3
Lutz MT, Helmstaedter C (2005) EpiTrack: tracking cognitive side effects of medication on attention and executive functions in patients with epilepsy. Epilepsy Behav 7:708–714. https://doi.org/10.1016/J.YEBEH.2005.08.015
Martin RC, Griffith HR, Faught E et al (2005) Cognitive functioning in community dwelling older adults with chronic partial epilepsy. Epilepsia 46:298–303. https://doi.org/10.1111/j.0013-9580.2005.02104.x
Matsuoka E, Saji M, Kanemoto K (2019) Daytime sleepiness in epilepsy patients with special attention to traffic accidents. Seizure 69:279–282. https://doi.org/10.1016/j.seizure.2019.04.006
Miller LA, Galioto R, Tremont G et al (2016) Cognitive impairment in older adults with epilepsy: characterization and risk factor analysis. Epilepsy Behav 56:113–117. https://doi.org/10.1016/j.yebeh.2016.01.011
Mwangala PN, Kariuki SM, Nyongesa MK et al (2018) Cognition, mood and quality-of-life outcomes among low literacy adults living with epilepsy in rural Kenya: a preliminary study. Epilepsy Behav 85:45–51. https://doi.org/10.1016/j.yebeh.2018.05.032
Najm IM, Wang Y, Shedid D et al (1998) MRS metabolic markers of seizures and seizure-induced neuronal damage. Epilepsia 39:244–250
Perrine K, Hermann BP, Meador KJ et al (1995) The relationship of neuropsychological functioning to quality of life in epilepsy. Arch Neurol 52:997–1003. https://doi.org/10.1001/archneur.1995.00540340089017
Piazzini A, Canevini MP, Turner K et al (2006) Elderly people and epilepsy: cognitive function. Epilepsia 47:82–84. https://doi.org/10.1111/j.1528-1167.2006.00884.x
Pitkänen A, Sutula TP (2002) Is epilepsy a progressive disorder? Prospects for new therapeutic approaches in temporal-lobe epilepsy. Lancet Neurol 1:173–181
Rai D, Kerr MP, McManus S et al (2012) Epilepsy and psychiatric comorbidity: a nationally representative population-based study. Epilepsia 53(6):1095–2103. https://doi.org/10.1111/j.1528-1167.2012.03500.x
Samarasekera SR, Helmstaedter C, Reuber M (2015) Cognitive impairment in adults with epilepsy: the relationship between subjective and objective assessments of cognition. Epilepsy Behav 52:9–13. https://doi.org/10.1016/j.yebeh.2015.08.013
Tailby C, Kowalczyk MA, Jackson GD (2018) Cognitive impairment in epilepsy: the role of reduced network flexibility. Ann Clin Transl Neurol 5(1):29–40
Tang V, Kwan P, Poon WS (2013) Neurocognitive and psychological profiles of adult patients with epilepsy in Hong Kong. Epilepsy Behav 29:337–343. https://doi.org/10.1016/j.yebeh.2013.07.027
Trimble MR (1988) Cognitive hazards of seizure disorders. Epilepsia 29:S19–S24. https://doi.org/10.1111/j.1528-1157.1988.tb05787.x
Velissaris SL, Wilson SJ, Saling MM et al (2007) The psychological impact of a newly diagnosed seizure: losing and restoring perceived control. Epilepsy Behav 10:223–233. https://doi.org/10.1016/j.yebeh.2006.12.008
Voltzenlogel V, Vignal JP, Hirsch E, Manning L (2014) The influence of seizure frequency on anterograde and remote memory in mesial temporal lobe epilepsy. Seizure 23:792–798. https://doi.org/10.1016/j.seizure.2014.06.013
Wallin JEW (1912) Eight months of psycho-clinical research at the New Jersey State Village for Epileptics, with some results from the Binet-Simon testing. Epilepsia A3:366–380
Witt JA, Helmstaedter C (2012) Should cognition be screened in new-onset epilepsies? A study in 247 untreated patients. J Neurol 259:1727–1731. https://doi.org/10.1007/s00415-012-6526-2
Witt JA, Helmstaedter C (2015) Cognition in the early stages of adult epilepsy. Seizure 26:65–68
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Jarčušková, D., Palušná, M., Gazda, J. et al. Which clinical and neuropsychological factors are responsible for cognitive impairment in patients with epilepsy?. Int J Public Health 65, 947–956 (2020). https://doi.org/10.1007/s00038-020-01401-7
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DOI: https://doi.org/10.1007/s00038-020-01401-7