Assessing cognition and quality of life in people with epilepsy: A feasibility study for mild and marked cognitive...

Cognitive performance in people with epilepsy (PwE) and the optimal approach to cognitive testing requires further investigation. The primary objective of this study was to assess the feasibility of using Creyos in PwE, a reliable and validated online cognitive battery. Our exploratory secondary analyses included comparing PwE's performance to age- and sex-matched norms and their performance on the online battery to performance on the Telephone Interview for Cognitive Status (TICS), functioning scales, and the Quality of Life in Neurological Disorders (Neuro-QOL) questionnaire. Participants (N = 48; 94% with drug-resistant epilepsy) underwent the battery on a tablet, which met feasibility criteria (93% consent rate, 94% completion rate). Participants performed worse than matched norms on 11 of the 12 battery's tests and its three domains: short-term memory, reasoning abilities and verbal processing (p < 0.01). Scores on the overall battery and TICS were moderately correlated (r = 0.50, p < 0.001) but there was negligible agreement (κ = 0.19, 95% CI = -0.04-0.41). There were no associations between patient characteristics and mild (Z ≤ -1) or marked (Z ≤ -1.5) impairment on the battery or International Classification for Cognitive Disorders in Epilepsy domains, except for executive functioning and age of epilepsy onset (p < 0.05). On the Neuro-QOL, participants (N = 42) scored significantly worse than the reference population on satisfaction with social roles/activities, subjective cognitive functioning, and anxiety. Most participants (64%) underestimated their cognitive abilities. Overall, this study was the first to establish feasibility of this online cognitive battery in PwE and provided further insight into the cognitive performance and QOL of people with drug-resistant epilepsy.