[Assessment of cognitive functions in drug-refractory epileptic patients]

During an epileptic seizure, cortical neurons produce patterns of excessive synchronized electric discharge, which leads to various neurobio- logical, cognitive, and affective consequenc- es. At least 70% of epileptic patients can be characterized by varying degrees of cogni- tive deficits that may extend to language, executive functions and memory functioning. Drug-refractory epilepsy (DRE), which affects about one third of the patient population can negatively affect everyday functioning and quality of life. This pilot study aims to construct and examine the neuropsycho- logical profile of people with DRE within the framework of a longitudinal research project.

A total of 33 subjects (21 women and 12 men; age range: 21-66 years, M = 41.49, SD = 15.75) were included in our study. A number of 17 drug-resistant epilepsy patients (13 women and 4 men; age range: 21-66 years, M = 46.6, SD = 13.5) and 16 matched controls (8 women and 8 men; age range: 23-59 years, M = 34.13, SD = 17.52) were included in the sample. The Montreal Cognitive Assessment was used as a preliminary screening tool. Executive functions were assessed by the letter and semantic fluency tests, visuo-spatial memory was tested using the Rey-Osterrieth Complex Figure Test (ROCFT), and language functions were assessed using the De Renzi Token Test.

Our results showed significantly lower performance in the patient group compared to controls regarding almost all executive functions (verbal fluency tasks, p < 0,05), memory functions (ROCFT delayed recall, p = 0.02) and the Token test assessing language functions (p = 0.009).

Consistent with the literature data, DRE patients in this study sample performed significantly worse than the control group in both higher-order cognitive functioning, memory functioning and speech comprehension. The present test battery can be used to map the cognitive profile of DRE patients.