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Epilepsy associated cognitive dysfunction and addiction: Possible mechanisms and clinical challenges
Anshul1, Romanpreet Kaur1, Shamsher Singh1
1Neuropharmacology Division, Department of Pharmacology, ISF College of Pharmacy, Moga 142001, Punjab, India.
Physiology & Behavior
|June 13, 2026
Summary
Epilepsy, cognitive impairment, and addiction share neurobiological pathways, creating a cycle of worsening health. Integrated care addressing seizures, cognition, and substance use is crucial for better patient outcomes and reduced mortality.
Area of Science:
- Neuroscience
- Neurology
- Addiction Medicine
Background:
- Epilepsy involves seizures and cognitive impairment, significantly impacting patient quality of life.
- Shared neurobiological pathways link epilepsy, cognitive deficits, and substance use disorders.
- Current seizure-focused care often overlooks the complex interplay between these conditions.
Purpose of the Study:
- To present an integrated framework linking epilepsy, cognition, and addiction.
- To elucidate the shared and interacting neurobiological mechanisms.
- To highlight clinical challenges and propose comprehensive management strategies.
Main Methods:
- Review of mechanistic and clinical literature.
- Analysis of neurobiological pathways including neuroinflammation, oxidative stress, and neurotransmitter systems.
- Examination of clinical data on co-occurrence and treatment outcomes.
Main Results:
- Recurrent seizures trigger neuroinflammation and synaptic dysfunction, leading to cognitive deficits.
- Reward circuitry dysfunction increases susceptibility to substance use disorders.
- A bidirectional cycle exists where substance use exacerbates epilepsy and cognitive decline, complicated by epigenetic changes and neuroplasticity.
Conclusions:
- Integrated, multidisciplinary care is essential, combining neurology, psychiatry, neuropsychology, and addiction medicine.
- Therapeutic strategies must include cognitive rehabilitation, behavioral interventions, and addiction management.
- Future research should focus on precision medicine, dual-targeted interventions, and digital health technologies.
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