The changes in cognitive impairment in patients with epilepsy during the disease course (On example of executive functions)

Abstract

Objective. To identify the relationship between executive functions (EF), personality traits and clinical characteristics of disease course. Material and methods. One hundred and five patients with partial epilepsy, including temporal lobe epilepsy (61%), lobe epilepsy (33%) and other forms (6%), were examined. Mean age of the patients was 30.24±8,67 years. EF were studied using the the Wisconsin Card Sorting Test (WCST) in 25 out of 105 patients of the main group. The patients were followed-up after 5.5 years. Results. Correlations between the EF decline and the age, illness duration and disability was found. Seizure remission and its duration have a positive effect on EF indices. There were no correlations with the age at seizure onset, severity of seizures, amount of medications used, psychopathological symptoms and left-handedness. The WCST scores were worse in patients with temporal lobe epilepsy and patients with alexithymia. A follow-up examination showed the relationship between the further EF decline and the left-sided localization of the epileptic focus as well as the absence of seizure remission. No relationship between the EF deficit and antiepileptic treatment was found. Conclusion. The EF deficit was observed in all forms of epilepsy, it was correlated with disability of patients, may be aggravated by personality and neurobiological characteristics and increased with the persistence of seizures. Based on the results of the study, the achievement of remission is needed in treatment tactics for epilepsy to preserve cognitive functioning and social well-being of patients.