Getting Physical: A Specific Boost for Cognition in Epilepsy?

Abstract

Effect of Combined Physical Training on Cognitive Function in People With Epilepsy: Results From a Randomized Controlled Trial Feter N, Alt R, Häfele CA, et al. Epilepsia. 2020;61(8):1649-1658. doi:10.1111/epi.16588. PMID: 32602966. Objective: To examine the effect of 12-week exercise program on cognitive function in people with epilepsy. Methods: Twenty-one physically inactive patients were randomized into 2 groups: the exercise group (EG) or the control group. Exercise group performed 12 weeks of combined physical training. Control group was advised to maintain usual daily activities. Exercise group received a structured, individually supervised exercise program with two 60-minute sessions per week. Each session included warmup (5 minutes), aerobic (15-20 minutes at 14-17 on Borg scale), strength (2-3 sets, 10-15 repetitions), and 5-minute active stretches. Sociodemographic characteristics, clinical information, memory (Digit Span Test [DST]), executive function (Trail Making Test [TMT] A and B), Stroop Color and Word Test, a verbal fluency task, global cognitive function (Montreal Cognitive Assessment [MoCA]), anthropometric measurements (weight, height, and hip and waist circumferences), cardiorespiratory fitness (maximal oxygen consumption [ (Formula presented.) o2max]), and strength (dynamometer) were measured at baseline and after the 12-week intervention. Results: Exercise decreased time spent on TMT-A from baseline to postintervention (difference = −7.9 seconds, 95% CI = −14.5 to −1.3, P =.023). Exercise group improved total number of words on the verbal fluency task after intervention (difference = 8.1 words, 95% CI = 3.0-13.2, P =.002). Exercise group also improved the score on MoCA at 1.7 (95% CI = 0.1-3.3, P =.043) points. We observed a 22.4% (95% CI = 13.1-31.6, P =.021) improvement in executive function in EG. No effect of group, time, or group × time was observed on any other cognitive test. Changes in (Formula presented.) o2max were negatively associated with changes in performance on DST (r = −0.445, P =.049) and overall memory score (r = −0.544, P =.042). Significance: This randomized controlled trial provided the first evidence that combined physical training improves executive function in adults with epilepsy, showing main improvements in attention and language tasks. Physical exercise should be encouraged for people with epilepsy to reduce the burden on cognitive function associated with this disease.