An Interplay Between Post-Traumatic Epilepsy and Associated Cognitive Decline: A Systematic Review.

Area of Science:

• Neurology
• Neuroscience
• Clinical Research

Background:

• Post-traumatic epilepsy (PTE) is a significant neurological complication following traumatic brain injury (TBI).
• PTE can severely impact patients' quality of life and impose a substantial socioeconomic burden due to long-term functional deficits, especially cognitive impairment.
• The precise relationship between TBI, PTE, and subsequent cognitive dysfunction remains inadequately understood.

Approach:

• A systematic literature search was conducted across six major databases (MEDLINE, Embase, CINAHL, Psych INFO, Web of Science, Cochrane).
• Relevant clinical studies published between 1996 and 2021 investigating the link between PTE and cognition in TBI patients were included.
• The Newcastle-Ottawa Scale (NOS) was employed to evaluate the methodological quality of the selected studies.

Key Points:

• Six studies involving 1,100 individuals were critically appraised, with follow-up periods ranging from 6 months to 35 years.
• Five studies indicated poorer cognitive performance in individuals with PTE compared to those without.
• While the direct association was not statistically significant after covariate adjustment, a trend toward significance was observed.

Conclusions:

• This systematic review suggests a potential association between PTE and cognitive decline in TBI patients, with cognitive impairment persisting for up to 35 years post-injury.
• Limitations include variations in sample sizes, follow-up durations, and neuropsychological assessment tools.
• Standardized cognitive assessments in future research are recommended to solidify the TBI-PTE-cognitive dysfunction link and guide therapeutic strategies.