Neurobehavioural comorbidities of epilepsy: towards a network-based precision taxonomy

Hermann, Bruce P.; Struck, Aaron F.; Busch, Robyn M.; Reyes, Anny; Kaestner, Erik; McDonald, Carrie R.

doi:10.1038/s41582-021-00555-z

Cited by 69 publications

(105 citation statements)

References 280 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There are now considerable evidence that challenge the classical lesion model of understanding cognition in focal epilepsy (31), which is in line with the result of the present study. Hermann et al suggest in their review an expanded framework for assessment of cognitive risks in epilepsy, not only including etiology, comorbidities, and treatment, but also genomic, medical, social, and life-style factors should be addressed for a more comprehensive evaluation (31).…”

Section: Memory and Attentionsupporting

confidence: 91%

Similar Profile and Magnitude of Cognitive Impairments in Focal and Generalized Epilepsy: A Pilot Study

et al. 2022

View full text Add to dashboard Cite

Introduction: Cognitive impairments in epilepsy are not well-understood. In addition, long-term emotional, interpersonal, and social consequences of the underlying disturbances are important to evaluate.Purpose: To compare cognitive function including language in young adults with focal or generalized epilepsy. In addition, quality of life and self-esteem were investigated.Patients and Methods: Young adults with no primary intellectual disability, 17 with focal epilepsy and 11 with generalized epilepsy participated and were compared to 28 healthy controls. Groups were matched on age (mean = 26 years), sex, and education. Participants were administered a battery of neuropsychological tasks and carried out self-ratings of quality of life, self-esteem, and psychological problems.Results: Similar impairments regarding cognitive function were noted in focal and generalized epilepsy. The cognitive domains tested were episodic long-term memory, executive functions, attention, working memory, visuospatial functions, and language. Both epilepsy groups had lower results compared to controls (effect sizes 0.24–1.07). The total number of convulsive seizures was predictive of episodic long-term memory function. Participants with focal epilepsy reported lower quality of life than participants with generalized epilepsy. Lowered self-esteem values were seen in both epilepsy groups and particularly in those with focal epilepsy. Along with measures of cognitive speed and depression, the total number of seizures explained more than 50% of variation in quality of life.Conclusion: Interestingly, similarities rather than differences characterized the widespread cognitive deficits that were seen in focal and generalized epilepsy, ranging from mild to moderate. These similarities were modified by quality of life and self-esteem. This study confirms the notion that epilepsy is a network disorder.

show abstract

Section: Memory and Attentionsupporting

confidence: 91%

Similar Profile and Magnitude of Cognitive Impairments in Focal and Generalized Epilepsy: A Pilot Study

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Indeed, according to this model, epilepsy comorbidity should be consequent to the epilepsy syndrome and its characteristics (etiology, onset, frequency, and treatment). The improvement in cognitive, neuroimaging, and clinical research highlighted neurobehavioral features heterogeneity leading to a challenge to the classic paradigm ( 62 ). For example, executive dysfunction, long considered as a pathognomonic feature of the frontal lobe epilepsy, has also been highlighted in the forms of TLE.…”

Section: From Classic Paradigm To Bidirectional Hypothesismentioning

confidence: 99%

“…In a study of patients with refractory epilepsy, polymorphisms in the brain-derived neurotrophic factor (BDNF) gene were associated with depression, whereas alterations in the catechol-omethyltransferase (COMT) gene were associated with anxiety disorders ( 100 ). In addition, epigenomic, transcriptomic, and proteomic alterations certainly play a role in the development of mostly unknown neurocognitive comorbidities ( 62 ). Environmental factors are also known to be associated with neurobehavioral disorders.…”

Section: From Classic Paradigm To Bidirectional Hypothesismentioning

confidence: 99%

“…Environmental factors are also known to be associated with neurobehavioral disorders. The stigma of epilepsy and its prevalence in poorer and less educated settings with under resourced medical services certainly plays a major role in the development of psychiatric comorbidities and overall quality of life ( 62 ). Indeed, a higher cognitive level seems to have a protective role against the neurocognitive comorbidities of epilepsy ( 101 ).…”

Section: From Classic Paradigm To Bidirectional Hypothesismentioning

confidence: 99%

“…Intervention toward a better lifestyle through education and psychosocial therapy can contribute to the treatment of epilepsy comorbidities. This approach should be implemented in the clinical practice and tailored to the patient epilepsy and neuropsychiatric comorbidities ( 62 ).…”

Section: From Classic Paradigm To Bidirectional Hypothesismentioning

confidence: 99%

See 2 more Smart Citations

Temporal Lobe Epilepsy and Psychiatric Comorbidity

et al. 2021

View full text Add to dashboard Cite

Most focal seizures originate in the temporal lobe and are commonly divided into mesial and lateral temporal epilepsy, depending upon the neuronal circuitry involved. The hallmark features of the mesial temporal epilepsy are aura, unconsciousness, and automatisms. Symptoms often overlap with the lateral temporal epilepsy. However, the latter present a less evident psychomotor arrest, frequent clones and dystonic postures, and common focal to bilateral tonic–clonic seizures. Sclerosis of the hippocampus is the most frequent cause of temporal lobe epilepsy (TLE). TLE is among all epilepsies the most frequently associated with psychiatric comorbidity. Anxiety, depression, and interictal dysphoria are recurrent psychiatric disorders in pediatric patients with TLE. In addition, these alterations are often combined with cognitive, learning, and behavioral impairment. These comorbidities occur more frequently in TLE with hippocampal sclerosis and with pharmacoresistance. According to the bidirectional hypothesis, the close relationship between TLE and psychiatric features should lead to considering common pathophysiology underlying these disorders. Psychiatric comorbidities considerably reduce the quality of life of these children and their families. Thus, early detection and appropriate management and therapeutic strategies could improve the prognosis of these patients. The aim of this review is to analyze TLE correlation with psychiatric disorders and its underlying conditions.

show abstract

Cortical Thickness Patterns of Cognitive Impairment Phenotypes in Drug‐Resistant Temporal Lobe Epilepsy

Miron,

Müller,

Hohmann

et al. 2024

Annals of Neurology

View full text Add to dashboard Cite

ObjectiveIn temporal lobe epilepsy (TLE), a taxonomy classifying patients into 3 cognitive phenotypes has been adopted: minimally, focally, or multidomain cognitively impaired (CI). We examined gray matter (GM) thickness patterns of cognitive phenotypes in drug‐resistant TLE and assessed potential use for predicting postsurgical cognitive outcomes.MethodsTLE patients undergoing presurgical evaluation were categorized into cognitive phenotypes. Network edge weights and distances were calculated using type III analysis of variance F‐statistics from comparisons of GM regions within each TLE cognitive phenotype and age‐ and sex‐matched healthy participants. In resected patients, logistic regression models (LRMs) based on network analysis results were used for prediction of postsurgical cognitive outcome.ResultsA total of 124 patients (63 females, mean age ± standard deviation [SD] = 36.0 ± 12.0 years) and 117 healthy controls (63 females, mean age ± SD = 36.1 ± 12.0 years) were analyzed. In the multidomain CI group (n = 66, 53.2%), 28 GM regions were significantly thinner compared to healthy controls. Focally impaired patients (n = 37, 29.8%) showed 13 regions, whereas minimally impaired patients (n = 21, 16.9%) had 2 significantly thinner GM regions. Regions affected in both multidomain and focally impaired patients included the anterior cingulate cortex, medial prefrontal cortex, medial temporal, and lateral temporal regions. In 69 (35 females, mean age ± SD = 33.6 ± 18.0 years) patients who underwent surgery, LRMs based on network‐identified GM regions predicted postsurgical verbal memory worsening with a receiver operating curve area under the curve of 0.70 ± 0.15.InterpretationA differential pattern of GM thickness can be found across different cognitive phenotypes in TLE. Including magnetic resonance imaging with clinical measures associated with cognitive profiles has potential in predicting postsurgical cognitive outcomes in drug‐resistant TLE. ANN NEUROL 2024

show abstract

Neurobehavioural comorbidities of epilepsy: towards a network-based precision taxonomy

Cited by 69 publications

References 280 publications

Similar Profile and Magnitude of Cognitive Impairments in Focal and Generalized Epilepsy: A Pilot Study

Similar Profile and Magnitude of Cognitive Impairments in Focal and Generalized Epilepsy: A Pilot Study

Temporal Lobe Epilepsy and Psychiatric Comorbidity

Cortical Thickness Patterns of Cognitive Impairment Phenotypes in Drug‐Resistant Temporal Lobe Epilepsy

Contact Info

Product

Resources

About