Volume 14, Issue 3 (May & Jun 2023)
BCN 2023, 14(3): 385-396 |
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Tabibian F, Mehvari Habibabadi J, Maracy M R, Kahnouji H, Rahimi M, Rezaei M. Evaluation of Cognitive Impairment in Refractory Temporal Lobe Epilepsy Patients Concerning Structural Brain Lesions. BCN 2023; 14 (3) :385-396
URL: http://bcn.iums.ac.ir/article-1-2334-en.html
URL: http://bcn.iums.ac.ir/article-1-2334-en.html
Farinaz Tabibian1 
, Jafar Mehvari Habibabadi *1 , Mohammad Reza Maracy2 , Hossein Kahnouji1 , Mahtab Rahimi3 , Maryam Rezaei4
, Jafar Mehvari Habibabadi *1 , Mohammad Reza Maracy2 , Hossein Kahnouji1 , Mahtab Rahimi3 , Maryam Rezaei4
1- Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
2- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
3- Department of Psychology, School of Education and Psychology, University of Isfahan, Isfahan, Iran
4- Michener Institute at UHN, University of Toronto, Ontario, Canada.
2- Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.
3- Department of Psychology, School of Education and Psychology, University of Isfahan, Isfahan, Iran
4- Michener Institute at UHN, University of Toronto, Ontario, Canada.
Abstract:
Introduction: Temporal lobe epilepsy (TLE) is the most prevalent form of drug-resistant epilepsy with concurrent cognitive impairment. Prevention, earlier diagnosis, and personalized management of cognitive deficits in TLE require more understanding of underlying structural and functional brain Ialterations. No study has evaluated the performance of TLE patients in different cognitive domains based on their structural brain lesions.
Methods: In this study, 69 refractory TLE patients underwent magnetic resonance imaging (MRI) epilepsy protocol and several neuropsychological tests, consisting of the Wechsler adult intelligence scale-revised, Rey-Osterrieth complex figure test, verbal fluency test, digit span test, spatial span test, Wechsler memory scale-III, design fluency test, Rey visual design learning test, auditory-verbal learning test, and trail making test. MRI findings were classified into the following groups: Focal cortical dysplasia, gliosis, atrophy, mesial temporal sclerosis (MTS), tumor, vascular malformation, and other lesions or normal. Results of neuropsychological tests were compared between MRI groups using a generalized linear model with gamma distribution and log link.
Results: Patients with MTS showed better performance in general intellectual functioning, working memory, attentional span, and auditory-verbal learning compared to patients with non-MTS MRI lesions. Atrophy and focal cortical dysplasia had the largest differences from MTS.
Conclusion: Cognitive performance of refractory TLE patients varies concerning structural brain alterations. Further neuroimaging studies of TLE lead to prevention and more accurate management of cognitive decline in clinical settings.
Methods: In this study, 69 refractory TLE patients underwent magnetic resonance imaging (MRI) epilepsy protocol and several neuropsychological tests, consisting of the Wechsler adult intelligence scale-revised, Rey-Osterrieth complex figure test, verbal fluency test, digit span test, spatial span test, Wechsler memory scale-III, design fluency test, Rey visual design learning test, auditory-verbal learning test, and trail making test. MRI findings were classified into the following groups: Focal cortical dysplasia, gliosis, atrophy, mesial temporal sclerosis (MTS), tumor, vascular malformation, and other lesions or normal. Results of neuropsychological tests were compared between MRI groups using a generalized linear model with gamma distribution and log link.
Results: Patients with MTS showed better performance in general intellectual functioning, working memory, attentional span, and auditory-verbal learning compared to patients with non-MTS MRI lesions. Atrophy and focal cortical dysplasia had the largest differences from MTS.
Conclusion: Cognitive performance of refractory TLE patients varies concerning structural brain alterations. Further neuroimaging studies of TLE lead to prevention and more accurate management of cognitive decline in clinical settings.
Keywords: Temporal lobe epilepsy, Cognition, Magnetic resonance imaging, Neuropsychological tests, Drug-resistant epilepsy
Type of Study: Original |
Subject:
Clinical Neuroscience
Received: 2021/11/2 | Accepted: 2022/01/1 | Published: 2023/05/8
Received: 2021/11/2 | Accepted: 2022/01/1 | Published: 2023/05/8
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