Year: 2007
Type: article
Study design: Observational Study
Abstract: Cognitive Prognosis in Chronic Temporal Lobe Epilepsy. Hermann BP, Seidenberg M, Dow C, Jones J, Rutecki P, Bhattacharya A, Bell B. Ann Neurol 2006;60:80–87. Objective First, to determine whether patients with chronic temporal lobe epilepsy have a different cognitive trajectory compared to control subjects over a prospective 4-year interval; second, to determine the proportion of patients who exhibit abnormal cognitive change and their profile of demographic, clinical epilepsy, and baseline quantitative magnetic resonance imaging characteristics; and third, to determine the most vulnerable cognitive domains. Methods Participants with chronic temporal lobe epilepsy ( N = 46) attending a tertiary referral clinic and healthy control subjects ( N = 65) underwent neuropsychological assessment and reevaluation 4 years later. Analysis of test–retest patterns identified individual patients with adverse cognition outcomes. Results The prospective cognitive trajectory of patients with chronic temporal lobe epilepsy differs from age- and sex-matched healthy control subjects. Lack of practice effects is common, but frank adverse cognitive outcomes are observed in a subset of patients (20%–25%), particularly in vulnerable cognitive domains that include memory. Cognitive declines are associated with a profile of abnormalities in baseline quantitative magnetic resonance volumetrics, lower baseline intellectual capacity, as well as longer duration of epilepsy and older chronological age. Interpretation Cognitive prognosis is poor for a subset of patients characterized by chronicity of epilepsy, older age, lower intellectual ability, and more baseline abnormalities in quantitative magnetic resonance volumetrics.
Author: Cynthia L. Harden
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2048235718