Cognitive functioning in idiopathic generalised epilepsies: a systematic review and meta-analysis

Area of Science:

• Neurology
• Neuroscience
• Cognitive Science

Background:

• Idiopathic generalised epilepsies (IGE) are the most common inherited epilepsy group.
• Research is increasingly focused on understanding IGE phenotypes and their impact on education and occupation.
• Previous studies suggested a specific executive function deficit in juvenile myoclonic epilepsy (JME), a subgroup of IGE.

Purpose of the Study:

• To quantitatively synthesize cognitive function outcomes in individuals with IGE.
• To evaluate cognitive performance across various domains, including executive function.
• To investigate if a specific executive function deficit exists in JME and other IGE syndromes.

Main Methods:

• Systematic review and meta-analysis of 26 peer-reviewed, case-control studies published since 1989.
• Univariate random-effects meta-analyses were performed on seven cognitive factor-domains.
• Executive function outcomes were analyzed separately.

Main Results:

• Patients with IGE showed significantly lower scores in all cognitive factor-domains except visual-spatial abilities.
• Effect sizes for cognitive deficits ranged from 0.42 to 0.88 pooled standard deviation units.
• Contrary to expectations, no specific executive function deficit was identified in JME or other IGE syndromes; overall executive function scores were reduced by 0.72 standard deviation units.

Conclusions:

• Individuals with IGE experience pervasive cognitive impairment across multiple domains.
• The findings challenge the notion of a specific executive function deficit in JME.
• Cognitive deficits in IGE are more widespread than previously assumed, impacting overall function.